Tuesday, August 2, 2011

Professor Niels R Finsen Finsen Medical Light Institute at Copenhagen


Some six years ago the medical world watched with considerable curiosity the experiments of a young Danish physician, whose theories anent a "light cure" held out great promises. Since then the experimental stages have broad­ened until they include the realm of practicability. Today no name in the scientific catalogue is better known than that of Prof. Niels R. Finsen, of Copenhagen. Since the discoveries of Pas­teur, the Roentgen rays are, perhaps, the most wonderful addenda to the history of medicine. But while the latter may be termed the search lights of the modern surgeon and his class, in the particular field he has selected Professor Finsen stands absolutely alone.

The aim of Professor Finsen and the Finsen Medical Light Institute is the conquest of superficially seated consumption and cancer through the medium of both natural and artificial light. Many skin diseases yield to the methods em­ployed by the eminent discoverer. From a purely aesthetic standpoint, therefore, the light cure be­comes a distinct boon to mankind.

His researches and methods have opened up a territory almost unknown until Professor Finsen led the way, not ten years ago. Professor Wid­mark, of Stockholm, it is true, was the first to prove conclusively that sunburn is caused, not by heat rays, but through certain chemical rays contained in the light. Finsen himself does not hesitate to admit the validity of the other's prior­ity. But still to the Danish physician is due the knowledge that such and such rays in the sun's spectrum are bacteria-destroying, while others are of a healing and curative nature.

Working on this principle, bringing to his aid the electric current, experimenting constantly, ill, yet subjecting himself to personal tests in order to be certain, Professor Finsen stood ready finally to let others judge him by his perform­ances. The highest medical authorities in Europe and the United States have visited the Finsen Medical Light Institute at Copenhagen, and as a result of their approval almost every large city in the world is making ready to establish a plant for the treatment of such diseases as yield to the Finsen concentrated light.

With this much understood, the readers of the REVIEW OF REVIEWS will have little difficulty in following the writer on his tour of investigation of the Finsen Medical Light Institute in the capital city of Denmark. It is the purpose here to explain succinctly, yet without omission, what Professor Finsen himself told on that visit to the famous institution. Fortunately for the better understanding of things in general, the day is fast disappearing when men of medicine and science hold secret the knowledge which is the concern of all.

The new buildings of the Finsen Medical Light Institute are excellently suited for both research and clinical purposes. Located in Rosenvaenget, a handsome suburban district of Copenhagen, the electric street car service makes the institute easily available. No better evidence is needed as regards the rapid growth of the institution than the difference between the present spacious quar­ters and the low, almost barn like, structure occu­pied as recently as a year ago. Professor Finsen holds in no slight esteem the building where for five years he carried on his epoch making investi­gations in the realm of bacteriology and of light treatment. To him the grand and larger com­plex is but another phase in the gradual advance; the ever widening field where future problems can be met squarely with all the new methods that science can supply.

From first to last, the most vivid impression that a visit to the Finsen Medical Light Institute leaves behind is that of common sense. Whether it is Professor Finsen himself, speaking earnestly, enthusiastically, wrapped up entirely in the subject; whether it is those marvelous instruments, with their still more wonderful power of healing; whether it is the man or his method, it all appears so lucid, so self. explaining, that little questioning is required. However, should it become necessary to direct an inquiry, it is met with a reply that sets every doubt at rest.

Professor Finsen, accompanied by two assist­ants, leads the way to the main hall. Here the head nurse is in charge of thirty-six young women, whose task is evident at a glance. Stretched out on tables grouped in fours, and arranged in a semi-circle around the hall, thirty­-six patients are undergoing treatment. In order that the very best attention be bestowed, but one person is allotted each nurse at a time. For one hour and ten minutes at a stretch the treatment goes on, until the clock announces a recess, when another set of patients takes the place of those just treated.

And now Professor Finsen explains the mean­ing of it all. The majority of cases under treat­ment are of a particularly obstinate and disfigur­ing type of skin tuberculosis, lupus vulgaris. No certain remedy existed for the arresting of its progress until the Danish physician made the dis­covery that concentrated light could kill the microbes and heal the skin without leaving scars of consequence. Even with the light treatment, relapses still occur. It should be borne in mind that, by his previously established "red-light" treatment of smallpox, Professor Finsen had dis­covered a means whereby it could, in a measure, be successfully combated. He showed that by protecting the skin against the injurious action of the chemical rays of light it was possible to diminish the intensity of the inflammation. But, in the present instance, instead of excluding the blue, violet, and ultraviolet rays, as in the small­pox treatment, he makes use of their curative properties. All of which now seems very simple.

While Professor Finsen began his experiments with sunlight, and still employs the natural rays when weather conditions permit, yet the inconstancy of the northern sun has made it necessary to treat the majority of the cases with electric light.. For this reason it is more to the..point to dwell first on the construction of the electric light apparatus, which, with their power of 20,000 candles each, are nevertheless so designed that the intense heat developed becomes nil as the tremendous glare strikes direct1y on the patient's face. It is this ability to utilize the chemical action of the concentrated light, and exclude the heat giving quantity, which makes the observer look on in mute wonder.

The concentration apparatus consists of quartz lenses, framed in two brass tubes which can be moved, the one into the other, like two pieces of a telescope. Lenses of quartz are used because this material, in a far higher degree than glass, allows the ultraviolet rays of shortest wave length to pass through. For it is just these ultraviolet rays that have a considerable bactericidal effect. The apparatus for the concentration of sunlight, however, may be made of glass, since all the ul­traviolet rays here have longer wave lengths.

In that part of the electric apparatus which faces the arch lamp two lenses are inserted. After passing from the lamp the divergent rays are here concentrated, and then they pass through the brass tubes, at the distant end of which they meet again with two lenses of quartz. Between these two latter lenses there is distilled water which cools the light by absorbing the intensely heating ultra red rays, but does not impair the blue, violet, and ultraviolet ones. Four such apparatus for light concentration are fixed around each arch lamp, the whole supported from the ceiling.

As far as the curative implement is con­cerned, everything has been done now to rob the light rays of their heat. But still the light is too hot to be turned on the skin without working injury. Therefore, since the light it­self can be cooled off no further, the skin must be subjected to a cooling process. This is obtained through a little contrivance that consists of a brass ring closed at both ends with quartz plates. The brass ring also contains a small tube for the admission of running water and an­other tube to carry it off. By means of elastic bands the ring is now forced against that part of the skin that is to be treated. The cold, run­ning water cools it off to such a degree that the skin can now stand a concentration of rays with a heating force sufficient to set fire to a piece of wood.

This little apparatus has the additional func­tion that it removes the blood from that part of the skin against which the ring presses. This very essential feature makes it possible for the chemical light rays to penetrate where otherwise the blood would absorb these rays. The water is carried through a rubber tube from a reser­voir above, and after passing through the pres­sure apparatus, finds its outlet beneath the floor.

After the patient is placed on the table, which offers every facility for comfort and quick rear­rangement of position, the nurse puts on a pair of blue spectacles, to ward off the strong light that is reflected on the pressure apparatus. Pre­viously the physician in charge of that respective case has marked out the particular spot then to be treated. The size is about that of a ten cent piece.

Almost immediately the treatment begins a decided inflammation sets in; something in the nature of sunburn. As the case is treated from day to day the reddish brown lupus tissue disap­pears, giving way to a smooth, healthy surface. In this manner Professor Finsen and his able assistants have cured almost a thousand cases of this much dreaded tuberculosis of the skin.

Now that the process is fairly well understood, it is the more interesting to let the eye wander over this unique hall, with its equal number of patients and nurses. The head nurse, a woman of extraordinary intelligence, who speaks Eng­lish, French, German, and the Scandinavian lan­guages with equal fluency, keeps a watchful eye that every detail is carried out as prescribed by the professor or his staff. Taking into consideration that eight nationalities were represented at the mo­ment of the visit to the Finsen Medical Light Institute, it becomes apparent how neces­sary it is that the one in im­mediate charge has linguistic abilities. None know better than Professor Finsen how much the physical depends on the condition of the mind. By offering his patients men­tal comfort, by making them forget for the moment that they are elsewhere than among their own, he assists the efficacy of his own dis­covery, and leads the way for a final cure. Unbounded gratitude is the part of those. whom in this manner Pro­fessor Finsen has restored, to society and their own self­ esteem.

And so the great work goes on from day to day. Men and women of all ages and all classes, children of tender years, come to seek aid of this Danish physician. Let the description be as detailed as possible, let imagination supply that which description fails to tell, even then it is impossible to present a picture in complete consonance with what takes place. In the re­ceiving room scores of people are waiting to have judgment passed. on their particular afflic­tion. Others, with bandaged faces, testify by their appearance that they are already undergo­ing treatment. A glance ahead, and there lies the great hall, with its electric. light apparatus under those red-covered shades that throw out a subdued effect. Bending to their tasks, the nurses watch with scrupulous care how the in­tense glare proceeds on its microbe-destroying mission. And over all, whether present or ab. sent, hovers the dominating genius of the one man without whom medical science must have reckoned itself by that much poorer.

The treatment by sunlight differs in some es­sential points from that where the arc lamp is the agency. That is, in the open air tables are ranged side by side. The lenses, as will be seen from the illustration, are simpler in construction. But a tremendously strong light can be generated, and the water lenses used have the faculty of absorbing the ultrared rays, which give out much heat otherwise. If it were possible to obtain sun­light regularly, undoubtedly the out-of-door method would be the preferable one. But since the sun of the northern countries is a very fickle quantity, Professor Finsen has come to the con­clusion that the greater benefit lies in perfecting the electric appliances to such a point where the natural light can be dispensed with. As regards the relative strength of electric light and sunlight, Professor Finsen's experiments with microbe cul­tures has convinced him where sunlight kills the germs in a couple of minutes, electricity does the work in that many seconds.

One of the great advantages of the Finsen concentrated light treatment in general is that it is absolutely without pain. The patients suffer not the slightest inconvenience. And those who have watched the progress of certain aggravated cases declare that the entire physiognomy of the patient undergoes a change. The eyes take on an added brilliancy. The carriage becomes more erect. It were as if a new dawn had risen; a re­generation where the victim of his disease is once more to be restored to his fellow men. It is in the moral aspect of the case that the Finsen treatment works such wonderful change side by side with the physical.

In the removal of birthmarks, such as port­ wine stains, from the size of a dime to those covering the entire one side of a face, the con­centrated light treatment has proved very ef­ficacious. If physicians the world over would do nothing more than apply the Finsen light cure in this direction, the discovery would have justified itself by its results. It is, comfort to know that this facial disfigurement is doomed at last.

For anemic patients, Professor Finsen has ex­perimented successfully with what he terms his photo chemical baths. He claims that the red color of the exposed parts of the skin is caused principally by light. Hence his effort to restore the deficiency by subjecting the anemic patient to what is probably one of the most powerful arch lights ever constructed.

In the room set apart for this treatment the patients walk about naked, except for broad ­brimmed straw hats to protect the eyes. There is no glare, however, notwithstanding the tre­mendous light force generated, for the walls and the ceiling are tempered in yellow tones. The effect of this treatment is said to be exceedingly pleasant, a sense of exhilaration taking possession of the entire nervous system. A number of cures have already been reported, and there is every reason to believe that in this direction, likewise, Professor Finsen has taught the medical profes­sion a valuable lesson in therapeutics.

On the flat roof of the main building the sun baths take place. As in the room with the artificial light, here, too, the entire body of the patient is exposed to nature's health giving rays.

The sun bath as a complete health restorer, how­ever, is as yet a matter of the future. This much Professor Finsen himself admits.

If the visitor, like the writer, is fortunate enough to gain admittance to the great labora­tory, here he is brought face to face with what may be termed the cause, the effect of which is to be met with everywhere in the Finsen Medical Light Institute. By day or by night, as cir­cumstances decree, the professor and his associ­ates here pursue their studies in the realm of microcosm. Whatever new problems are to be solved by Professor Finsen, this splendid labora­tory will assist in making practicable. For it is not for the sake of experimentation, but be­cause he wants curative results, that Professor Finsen has sacrificed his own health and com­fort that others might be benefited through his researches.

Niels R. Finsen was the son of a well known Icelandic functionary; he was born some forty-­two years ago on one of the Faroe islands. His early education took place in Iceland, and from here he went to Copenhagen and entered the university for the purpose of studying medicine. It was in a small attic room of the old chirur­gical academy building that Professor Finsen be­gan his first investigations touching the effect of light on the human organism. Sophus Bang, a fellow student, now considered one of Europe's first anatomists, shared Finsen's enthusiasm as regards a complete reform of medical therapeu­tics. All kinds of schemes for the betterment of mankind were constantly discussed by the young students. Then ill health came to both. Bang sought refuge in Switzerland, where he gradually regained his strength, while Finsen remained at home to fight his battle single-handed against the disease that ever since has held him in its relentless grasp.

But ill health, which left him a badly shattered constitution, did not deter from pursuing the studies he had begun of his own accord. He was considered little short of queer when he began discussing the influence of sunlight on the human organism. True, it was admitted by the medical world that light influenced all animal life, but Finsen was alone in declaring that sun rays held the keys to a new method for treating certain diseases.

In 1890, Professor Finsen graduated from the Copenhagen University. Gradually it became clear to the skeptically inclined that there was much of common sense in what Finsen claimed for his discovery. Then, in an article, "The Influence of Light on the Skin," published in Hospitaltidende for July, 1893, he aroused general attention by declaring that in cases of small­pox cures could be effected by placing red cur­tains before all the windows of the sick room.

This was the beginning of what was to prove Professor Finsen's reward. In 1894, the year following the publication of his article, smallpox became epidemic in Copenhagen. Now was the time to put the matter to a test. Shortly pre­vious, Dr. Svensen, of Bergen, acting on the suggestion, had tried the "red-room" treat­ment with splendid results. Professor Fjellberg now did the same thing with the Copenhagen smallpox cases. Everywhere the medical fra­ternity applauded the results obtained; especi­ally because, by preventing suppuration, the dis­ease could run its course without leaving those dreaded scars.

While medicine had gained a grand victory, to Professor Finsen the "red-room" treatment was only a negative result. Instead of excluding the light rays, as in smallpox treatment, he wanted the "positive" side made applicable; the best use of the chemical light rays for cura­tive purposes. To gain this end he experimented on a lupus patient at the electric light station. The sufferer, who for more than eight years had tried every remedy to get rid of his distress­ing malady, but without success, was restored to health through the concentrated light cure. And now both moral and monetary assistance came to the discoverer of the treatment.

In 1896, the Municipal Hospital of Copenha­gen placed a piece of ground at the disposal of Professor Finsen. Here were erected several buildings, unpretentious, it is true, but sufficient for the time being. The Finsen Medical Light Institute was organized through the munificence of Messrs. Hagemann and Joergensen, two wealthy residents of Copenhagen. The Danish Govern­ment likewise gave a considerable sum for the furtherance of the institution which, beginning with two patients, now treats hundreds daily­. On an average, the cases treated are of eleven years standing; one individual, having suffered from lupus forty-five years, likewise showing marked improvement. But, as a matter of course, where the concentrated light treatment is begun in the earlier stage, improvement and permanent cure follow much more rapidly.

With its removal to its present quarters in Rosenvaengetthe Finsen Medical Light Insti­tute has entered on its career of real stability, Every department is organized on a basis of best results. Professor Finsen has himself charge of the laboratory, with Dr. Forchhammer as chief physician, and Dr. Reyn the first assistant. The staff includes chemists of national renown, ex­pert electricians, and nurses whose work is abso­lutely unique in the profession of healing.

Originally published in The American Review of Reviews Magazine.  1902.

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